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4.
Goal of Medicare… Tommy Douglas <ul><li>Sharing risk </li></ul><ul><ul><li>getting people the health care they need when they need it </li></ul></ul><ul><li>Keeping people well not just patching them up once they get sick </li></ul>

5.
The Tyranny of the Acute <ul><li>As long as citizens think of the sickness care system whenever they hear the word ‘health’ we are not going to be able to reorient health systems. </li></ul>

6.
Canadian Institute for Advanced Research <ul><ul><li>25% health attributable to health care system </li></ul></ul><ul><ul><li>15% biology and genetics </li></ul></ul><ul><ul><li>10% physical environment </li></ul></ul><ul><ul><li>50% social and economic environments </li></ul></ul>

17.
Boom, Bust and Echo <ul><li>“ Over the next 2 decades, as 9.8 million baby boomers turn 50, we will witness a significant exodus from big-city Canada to small-town Canada. The participants in this exodus are going to need the same hospitals that provincial governments want to close in the mid-1990’s” </li></ul>

18.
Boom, Bust and Echo <ul><li>“ Governments should view small-town hospitals not as a burden on the health care budget but as a powerful tool for the economic development of rural regions . In the years to come, the reassuring presence of a good local hospital will act as a magnet for relatively prosperous new retirees, whose arrival will create new demand for good and services.” </li></ul>

19.
Boom, Bust and Echo <ul><li>“… . bring their new wealth with them. </li></ul><ul><li>… . already happening in the Okanagan and other parts of the B.C. interior </li></ul><ul><li>… ..one scenario where increased population does lead to increased prosperity….. A Region that loses its local hospital may be losing its best chance for economic rebirth. ” </li></ul>

32.
“ Health is Politics” <ul><li>“ If you want to move healthy public policies forward, you have to have political dynamite ” </li></ul><ul><li>Dr. Halfan Mahler </li></ul>

33.
<ul><li>HOWEVER…… </li></ul><ul><li>Public policy usually follows public opinion…. </li></ul><ul><li>BECAUSE……. </li></ul><ul><li>Doing the right thing is very difficult is the people aren’t onside… </li></ul><ul><ul><li>“ Father knows best” not great politics </li></ul></ul>

35.
Political Will to do the right thing <ul><li>Dramatically improves with an educated public…… health literacy </li></ul><ul><ul><ul><li>Illiteracy for Afghan women - ‘blind’ </li></ul></ul></ul><ul><ul><ul><li>Can’t see what’s going on </li></ul></ul></ul><ul><li>Citizens pulling healthy public policy…. Civic efficacy </li></ul>

36.
Values... Versus public opinion <ul><li>Public opinion ? </li></ul><ul><ul><li>sometimes very shortsighted </li></ul></ul><ul><ul><li>What’s in in for me ? </li></ul></ul><ul><ul><li>What we see in polling data </li></ul></ul><ul><li>Need to drill down to values… </li></ul><ul><ul><li>Deliberative dialogue </li></ul></ul><ul><li>Empowerment </li></ul><ul><ul><li>taking the time to educate and listen </li></ul></ul><ul><ul><li>speaking plain language </li></ul></ul><ul><ul><li>2 –way accountability </li></ul></ul>

37.
Values... Versus public opinion <ul><li>Public opinion ? </li></ul><ul><ul><li>sometimes very shortsighted </li></ul></ul><ul><ul><li>What’s in in for me ? </li></ul></ul><ul><ul><li>What we see in polling data </li></ul></ul><ul><li>Need to drill down to values… </li></ul><ul><ul><li>Deliberative dialogue </li></ul></ul><ul><li>Empowerment </li></ul><ul><ul><li>taking the time to educate and listen </li></ul></ul><ul><ul><li>speaking plain language </li></ul></ul><ul><ul><li>2 –way accountability </li></ul></ul>

38.
Health Literacy Quiz version 1 <ul><li>Is ‘surveillance’ ? </li></ul><ul><ul><ul><li>Pattern of disease </li></ul></ul></ul><ul><ul><ul><li>cameras in school corridors </li></ul></ul></ul><ul><li>Is ‘Accessibility’ </li></ul><ul><ul><ul><li>Getting the businessman to work from the suburbs </li></ul></ul></ul><ul><ul><ul><li>Ramps and closed captioning </li></ul></ul></ul><ul><li>Chronic Disease management </li></ul><ul><ul><ul><li>What or who is being managed ? </li></ul></ul></ul><ul><ul><ul><li>Isn`t this about the health care providers too ? </li></ul></ul></ul><ul><ul><ul><li>Why are we blaming the patients ? </li></ul></ul></ul><ul><ul><ul><li>How many specialty clinics should one human have to attend ? </li></ul></ul></ul><ul><li>Primary Care … provider, setting </li></ul><ul><ul><ul><li>Have you ever heard a real person say these words ? </li></ul></ul></ul>

39.
“ What we have here is a failure to communicate” Cool Hand Luke 1967

48.
5.Should we: <ul><li>A) assume that the 'grey tsunami' will bankrupt our health care system </li></ul><ul><li>B) include our aging population in the planning of strategies to keep them well </li></ul>

49.
6. Is the best approach to food security: <ul><li>A) food banks and vouchers </li></ul><ul><li>B) Income security,affordable housing, community gardens and community kitchens and a national food policy </li></ul>

50.
7. Pick the one that is NOT correct <ul><li>Pandemic Preparedness should focus on </li></ul><ul><li>Tamiflu for all </li></ul><ul><li>Working with the vets to keep avian flu a disease of birds </li></ul><ul><li>Making sure people wash their hands especially the doctors and nurses </li></ul><ul><li>Research on vaccines </li></ul><ul><li>Community care plans for our most vulnerable </li></ul>

51.
8.Governments should boast about: <ul><li>how much they spent on the sickness care system </li></ul><ul><li>the health of their citizens, leaving no-one behind </li></ul>

59.
Communiqué FMM September 2004 <ul><li>“ In addition, governments commit to accelerate work on a pan-Canadian Public Health Strategy . For the first time, governments will set goals and targets for improving the health status of Canadians through a collaborative process with experts. The Strategy will include efforts to address common risk factors, such as physical inactivity, and integrated disease strategies. First Ministers commit to working across sectors through initiatives such as Healthy Schools.” </li></ul>

60.
Health Goals for Canada <ul><li>As a nation, we aspire to a Canada in which every person is as healthy as they can be – physically, mentally, emotionally and spiritually. </li></ul>

63.
With the Public Health Map Generator, you can produce high quality, detailed maps of your own health data, in combination with extensive geography from our spatial data warehouse…

64.
GIS User ******* The Public Health Map Generator is a secure, web-based mapping application, accessible only to clients registered with the GIS Infrastructure at the Public Health Agency of Canada. All of the Infrastructure’s services, including the Public Health Map Generator, are available at no cost to all public health professionals in Canada.

69.
Population Health: Keeping Canadians healthy…. <ul><li>‘ Citizen centered’ federalism… </li></ul><ul><ul><li>bottom up </li></ul></ul><ul><li>Strong common purpose…. </li></ul><ul><li>Local wisdom, local knowledge to get it done </li></ul><ul><li>Aligning all levels of government and all government departments to what is determined in communities. </li></ul>

70.
International WHO NGO Advisory Group Health Promotion <ul><li>Clear they need to be included </li></ul><ul><li>Clear they know it’s politics </li></ul><ul><li>strengths </li></ul><ul><ul><li>Respond to needs in community </li></ul></ul><ul><ul><li>Identify policy gaps </li></ul></ul><ul><ul><li>Advocacy and consensus building </li></ul></ul><ul><ul><li>Resource mobilization </li></ul></ul>

72.
Ministries of Diseases Dr. Harry Jeene <ul><li>Mirroring the way Northern countries are structured, developing countries also fund health as a set of diseases. </li></ul>

73.
Health Promotion in partnership Dr. Harry Deene <ul><li>There is not much profit to be made in Health Promotion, certainly not for the Pharma, fast food and entertainment industries, </li></ul><ul><li>Neither for the donors who require quick wins, direct attributions and an increasing preference for commodities. </li></ul><ul><li>There is even little in it for the formal health care providers, including those in primary health care </li></ul><ul><li>Major shifts in thinking are required, and these can only be driven by communities working as full and equal partners with the formal health system, especially at the Primary Care level. </li></ul>

74.
Dr. Harry Deene <ul><li>We have missed our Alma Alta </li></ul><ul><li>2000 targets </li></ul><ul><li>We are missing our 2015 MDG targets </li></ul><ul><ul><li>(and where are health promotion, chronic conditions, mental health and trauma in these MDG's'anyway ?) </li></ul></ul><ul><li>Civil Society will have to exercise much more pressure to get health promotion on the agenda, North and South. </li></ul>

76.
<ul><li>“ The art of making the necessary possible” </li></ul><ul><li>Deciding what is necessary is political….. </li></ul><ul><li>We need great people to run for public office. </li></ul><ul><li>We need great people to want to be civil servants. </li></ul><ul><li>They need to be believers in ‘bottom up’ </li></ul>Putting the ‘poli’ back into Politics (& policy !)

78.
Sir Michael Marmot <ul><li>“ Evidence is not enough. There has to be the desire, the political will for change. Given that will - a big given but I am an optimist - the evidence of what works will be a great help.” </li></ul>

81.
Dr. John Hastings M.O.H. Toronto… on the occasion of his Presidency of the APHA , 1918 <ul><li>Every nation that permits people to remain under the fetters of preventable disease and permits social conditions to exist that make it impossible for them to be properly fed, clothed and housed so as to maintain a high degree of resistance and physical fitness; and, who endorses a wage that does not afford sufficient revenue for the home, a revenue that will make possible the development of a sound mind and body, is trampling on a primary principle of democracy. </li></ul>

83.
<ul><li>“ The care of the public health is the first duty of a statesman.&quot; </li></ul><ul><li>Benjamin Disraeli </li></ul><ul><li>Aspiring to become a statesman should be the first duty of every politician …… </li></ul>